Letters to the editor

Dear Editor,

Despite critics who have said that reforming California’s health care system was on life support, legislative leaders are still committed to fixing the broken health care system. Just this week, a new health care reform proposal was announced by Assembly Speaker Fabian Nunez (D-Los Angeles) and Senate Pro Tem Don Perata (D-Oakland) with the goal of covering millions of uninsured Californians.

California has 6.8 million uninsured men, women and children. This is more than any other state. Universal coverage is common ground legislative leaders and Gov. Arnold Schwarzenegger both support. However, compromise by all stakeholders – employers, labor, insurance companies, consumer groups, health care providers and the government. – will be required to reach the final goal.
The newest health reform proposal – ABx1 1 – appears to include compromises between the Speaker’s health reform proposal (AB 8) and the Governor’s plan, including a 6.5 percent sliding scale fee on employers, a 4 percent fee on hospitals, and a limited individual mandate for all Californians to purchase health insurance. This new proposal also includes a new $2 per pack tobacco tax to raise the additional funds necessary to cover more Californians.

While this proposal might not be the final solution, the cost of covering more Californians must be a shared responsibility. California’s hospitals, half of which are operating in the red, stepped up and agreed to a new 4 percent fee to help eliminate much of the $2.1 billion payment shortfall from the state’s Medi-Cal program.

The California Hospital Association (CHA) has not yet had an opportunity to fully analyze the newest health reform proposal, however it appears that a data collection and reporting provision in the proposal would create a new, independent state bureaucracy with unlimited powers to impose a second tax or levy fees on hospitals – independent of the Legislature, the Governor or the voters. This new independent bureaucracy could also arbitrarily determine the data elements to be collected and released.
While CHA remains committed to finding solutions to health reform, the Association strongly opposes the additional tax and financial burdens on California’s community hospitals.

C. Duane Dauner,
Sacramento
President and CEO,
California Hospital Association

Dear Editor,

Malcolm Mclachlan’s coverage (Gaming good for tribes, bad for problem gamblers, October 29th) of the UC Davis meeting on Indian Gaming gave a somewhat mistaken impression of the data I presented there on the relationship between Indian casinos and gambling-related mental disorders (problem and pathological gambling). To set the record straight:

1. There is no solid evidence of change in the overall rate of problem and pathological gambling among Californians during past decade’s steady expansion of Indian gaming in California.

2. The recent 7000-person sample survey on gambling in California (available at http://www.adp.cahwnet.gov/OPG/pdf/CA_Problem_Gambling_Prevalence_Survey-Final_Report.pdf), conducted by independent university-based researchers, tested whether living close to a casino (or other concentrated gaming opportunity) predicted an increased likelihood of gambling-related disorders—and found no correlation.

3. A large amount of the take at casinos, lotteries, card rooms, and race tracks comes directly from that small proportion of players who are problem and pathological gamblers. The original Las Vegas/Atlantic City model—casino gambling far from home—creates a geographical and political isolation between the pools of money lost and the problems that may be associated with some of those losses. Gambling closer to home means that these funds are that much closer to where the problems play out.

Conclusion: experienced gamblers, with or without problems, will travel (if necessary) to play their favorite games.
And a recommendation: all gaming operators (including lotteries, casinos, pari-mutuel operators, card rooms, and internet gaming sites) have some level of responsibility to support the study, prevention, control, and treatment of problem and pathological gambling.

Dean R. Gerstein, PhD.
Claremont Graduate University